European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Aug 2023
Multicenter StudyChanges in injury patterns, injury severity and hospital mortality in motorized vehicle accidents: a retrospective, cross-sectional, multicenter study with 19,225 cases derived from the TraumaRegister DGU®.
In the last 20 years, the number of fatalities due to road traffic accidents (RTA) in Germany has steadily decreased from 7503 to 2724 per year. Due to legal regulations, educational measures and the continuous development of safety technology the number of severe traumatic injuries and injury patterns are most likely to change. The aim of the study was to analyse severely injured motorcyclists (MC) and car occupants (CO) that were involved in RTAs in the last 15 years and investigate the development and changes of injury patterns, injury severity and hospital mortality. ⋯ The severity of injuries and their incidence, especially head injuries, have decreased over the years and seem to contribute to a decreasing hospital mortality of polytraumatized MCs and COs injured in traffic accidents. Young drivers and an increasing number of seniors are the age groups at risk and require special attention and treatment.
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Eur J Trauma Emerg Surg · Aug 2023
ReviewConcepts, utilization, and perspectives on the Dutch Nationwide Trauma registry: a position paper.
Over the last decades, the Dutch trauma care have seen major improvements. To assess the performance of the Dutch trauma system, in 2007, the Dutch Nationwide Trauma Registry (DNTR) was established, which developed into rich source of information for quality assessment, quality improvement of the trauma system, and for research purposes. The DNTR is one of the most comprehensive trauma registries in the world as it includes 100% of all trauma patients admitted to the hospital through the emergency department. ⋯ However, in order to maximally exploit the possibilities of the DNTR, further development is required, for example, regarding data quality improvement and routine incorporation of health-related quality of life questionnaires. This would improve the quality assessment and scientific output from the DNTR. Finally, the DNTR and all other (European) trauma registries should strive to ensure that the trauma registries are eligible for comparisons between countries and healthcare systems, with the goal to improve trauma patient care worldwide.
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Eur J Trauma Emerg Surg · Aug 2023
ReviewThe role of fibrinogen in traumatic brain injury: from molecular pathological mechanisms to clinical management.
Fibrinogen is the substrate of plasma coagulation. It plays an important role in the formation of reticular network, which is crucial to the strength and stability of blood clots. In addition to directly participating in coagulation, fibrinogen also participates in the destruction of blood-brain barrier and neuroinflammation. ⋯ Considerable efforts have been made to understand the mechanisms by which fibrinogen damages the central nervous system. Combined with the latest research hotspots, potentially promising treatment strategies at the molecular level were discussed. We believe that understanding the role of fibrinogen-mediated damage in nerve and blood-brain barrier function will enable timely intervention in patients with nerve damage, and guide the development of novel targeted therapeutics.
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Eur J Trauma Emerg Surg · Aug 2023
ReviewCommunication failure in the prehospital response to major terrorist attacks: lessons learned and future directions.
Communication is key in efficient disaster management. However, in many major incidents, prehospital communication failure led to insufficient upscaling, safety concerns for the emergency responders, logistical problems and inefficient disaster management. ⋯ Despite reports of lessons learned in previous EMS responses, communication failures were still reported in most recent terrorist attacks. Governments should provide sufficient resources to equip hospitals, emergency departments, and ambulance services with (back-up) communication systems and invest in training. A European registration system is warranted. We provide proposals for improvement.
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Eur J Trauma Emerg Surg · Aug 2023
Multicenter Study Observational StudyInterinstitutional analysis of the outcome after surgery for type A aortic dissection.
To evaluate the impact of individual institutions on the outcome after surgery for Stanford type A aortic dissection (TAAD). ⋯ The present findings indicate that there are significant differences between hospitals in terms of early outcome after surgery for TAAD. Low hospital volume may be a determinant of poor outcome of TAAD.